Instruments and

Instrumentation for tooth

preparation

Instruments for
Tooth preparation

Hand Instruments

Rotary Instruments

Hand instruments
Hand instruments: Are those held by
hand to perform their function.

Hand Instruments

Cutting

Non-cutting

Non-cutting Instruments

:I.

Exploring instruments
Mouth mirrors & explorers.

;Two types of mouth mirror: left, front-surface reecting

right, rear-surface reecting. Note the double image in the
.rear-surface reecting mirror

II. Condensing instruments:

III.

Plastic instruments:
e.g. carvers, burnishers,
packing instruments.

IV. Finishing and polishing

instruments
e.g. interdental finishing strips.

V. Miscellaneous instruments:
e.g. spatulas, tweezers, cotton
pliers,

 Hand cutting instruments:

Are hand-hold instruments used to

cleave enamel or to cut dentin
and deliver their energy from the
operator's hand.

:Materials
Hand cutting instruments are
manufactured from two main materials:
Carbon steel is harder than stainless
steel, but when unprotected, it will
corrode.
Stainless steel remains bright under
most conditions but loses a keen edge
during use much more quickly than
does carbon steel.

 In addition, some instruments are made

with carbide inserts to provide more
durable cutting edges. Carbide, although
hard and wear resistant, is brittle and
cannot be used in all designs.
Other alloys of nickel, cobalt, or chromium
are used in the manufacture of hand
instruments, but they usually are
restricted to non-cutting instruments.

Instrument Design

Handle (shaft):
Are available in various
sizes and shapes.
They are commonly
eight-sided,
knurled to facilitate control.

Shank:

Connect the handle

to the working end.
They are normally smooth,
round, and tapered.
Shanks often have one or more
bends to avoid the instrument
having a tendency to twist in
use when force is applied.

Blade:

The blade is the working end

of the instrument and is
Connected to the handle by the
shank. Some instruments have a
blade on both ends of the handle
and are known as double-ended
instruments.
The blades are of many designs
and sizes, depending on the
function they are to perform.

 For non-cutting instruments, the part

corresponding to the blade is termed
the nib.
The end of the nib, or working surface,
is known as the face.

Contrangling
G.V. Blacks classified instruments
based on the number of shank angles,
as mon-angle (one), bin-angle (two),
triple-angle (three), or quadra-angle

Balance

allows for the concentration of force onto

the blade without causing rotation of
the instrument in the grasp.
Balance is accomplished by designing
the angles of the shank so that the
cutting edge of the blade must be
within 2 to 3 mm from the central axis
of the shaft .

:Instrument Nomenclature
Black's classification system categorized
instruments by:
1) Function (e.g., scaler, excavator).
2) Manner of use (e.g., hand condenser).
3) Design of the working end (e.g., spoon
excavator).
4) Shape of the shank (e.g., mono-angle, binangle).
These names were combined to form the
complete description of the instrument (e.g.,
bin-angle spoon excavator).

Operative Cutting Instrument

Formula
G.V. Black's established a numeric
formula that describes:
a- The dimensions of an instrument.
b- The angulation of the instrument.

 These are placed on the handle using a

code of three or four numbers
separated by dashes or spaces.
e.g. 10-85-8-14.

When the cutting edge of an instrument is

at a right angle to the length of a blade:
1. First number indicates the

width of the

blade in tenths of a mm.

2. The second number: represents the

Length of the blade in millimeters, that is,

from the shank to the cutting edge.
3. The third number: the Angle the blade
makes with the long axis of the handle. This
angle is expressed in centigrade.

When the cutting edge of an instrument

is at an angle other than a right angle
to the length of a blade,

a fourth unit is added to the basic three

unit formula.
This number is placed in the second
position of the formula, represents the
angle that the cutting edge of the
instrument makes with the long axis of
the handle.

1. First number indicates the width of the

blade in tenths of a mm.
2. The second number: represents the Angle
that the cutting edge of the instrument
makes with the long axis of the handle.
3. The third number: represents the Length of
the blade in millimeters from the shank to
the cutting edge.
4. The fourth number: the Angle the blade
makes with the long axis of the handle, or
the plane of the instrument. This angle is
expressed in centigrade.

Types of hand
cutting
instruments

Chisel Family

Hatchet Family

Chisels
1. Straight Chisel:
This is an instrument used primarily for:
a- Planning
b- Cleaving enamel
Has a straight shank & blade.
Characterized by a blade that
terminates in a cutting edge formed
by a one-sided bevel .
The cutting edge of a chisel is at a
right angle to the plane of the shaft.

2. Wedelsteadt Chisel
Is a modified straight chisel.
Has a slight curvature from
the shank up to the cutting
edge.
The blade has either a distal
or a mesial bevel.

3. Bin-angle chisel

Is frequently double-ended, having

one cutting edge mesial, and another
cutting edge distal.
When the cutting edge is mesial to the
shaft, it is termed
"CONTRA-BEVELED" OR
REVERSE BEVELED chisel.

4. HOE:
A form of the chisel in which
the angle of the blade more
nearly approaches a right angle.
The cutting edge would be at a
right angle to the plane of the
instrument.
Is frequently used with a pull
motion. While the chisel is
normally used with a push
motion.

5. Angle Former
used for sharpening line angles.
It is mono-angled.
The cutting edge at an angle
(other than 90)to the axis of
the blade.
The angled cutting edge as well
as the sides of the blade of the
angle former are beveled to
form three cutting edges.

Hatchets
I. Enamel Hatchet:
Is a chisel bladed instrument with
the cutting edge in the same plane
of the handle
e.g., if the blade of a hatchet is at
right angles to the shaft, the
cutting edge would be parallel to
the shaft.
Used for planning and cutting
enamel.
Comes as right & left types for use
in opposite sides of the preparation.

:II. Excavators
Uses:
Excavation and removal of carious dentin.
Shaping of the internal parts of the cavities.
Forms:
1. Hatchet excavator.
2. Hoe excavator.
3. Spoon excavator.
4. Discoid excavator.
5. Cleoid excavator.

Hatchet Excavator. 1
The blade is bibeveled; has
two bevels of equal
dimension, placing the cutting
edge in the center.
Always single-ended.
Used in scrapping action for
refining retention and
sharpening line & point
angles.

Spoon Excavator. 2
Is frequently the instrument of choice
for the removal of carious dentin.
The cutting edge is rounded.
The shape of the tip and, to some
degree, the spooning or scooping action
of the instrument in caries removal
provides an appropriate name.
Like all double-planed instruments, the
spoon is designed for lateral scraping.
It is always a paired instrument, with
the curve of one blade directed from
right to left and that of the other from
left to right.
The circular cutting edges of this
instrument are ground to a thin
sharpness.

Discoid Excavator. 3
Disk-like, the blade is circular
in form.
The cutting edge extending
around the whole periphery.
Used for caries removal.
It is also, used presently as a
carving instrument for
amalgam and wax.

Cleoid Excavator. 4
Claw-like.
Sharp pointed blades, with
cutting edges on two sides
of the blade.
Used as carving
instrument.

:Gingival margin trimmer (GMT).3

Is a modified hatchet.
Two distinct modifications of the basic
hatchet design are noted:
a- While the hatchet has a straight blade,
the blade of the gingival margin trimmer
is curved.
b- The cutting edge of a gingival margin
trimmer is at an angle other than right
angle to the axis of blade, the same as
hatchet.

The curved blade accentuates the lateral

scraping ability of the instrument.
Used in beveling the gingival enamel
margins of proximo-occlusal preparation.

Part II

Cutting Instrument Bevels

Bevels

Single Bevel

Right & Left

Bi-Bevel

Mesial & Distal

Single Beveled Instruments

Most hand cutting instruments
have on the end of the blade a
single bevel that forms the primary
.Additional
cutting edge
two secondary cutting
edges
extend from the primary cutting edge
for the
length of the blade. This allows
cutting in 3 directions.

Bi-beveled instruments

Bi-beveled instrument
have
two bevels that form the
,cutting edge
.e.g. hatched excavator

Single beveled instrument such as

spoon excavator and gingival margin
trimmer are used with lateral cutting
.motion
Such instruments must be made in pairs
Having the bevels on opposite sides of
.the blade i.e. right & left beveled
Indicated by appending the letter R or L
.to the instrument formula

Right and left bevels

To determine this, the primary cutting edge
.is held down and pointing away
If the bevel appears on the right, it is the
right instrument of the pair, when used it is
moved from right to left.
The opposite is true for the left instrument
of the pair.
One instrument is used for work on one
side of the preparation and the other for the
.opposite side of the preparation

Single beveled instrument with The

cutting edge is perpendicular to the
axis of the handle e.g. bin-angle chisel,
Wedelstaedt chisel have mesial or

distal bevel.

If one observe the inside

of
;curvature or the angle
The primary bevel is not
visible, the instrument has
distal bevel.
The primary bevel is visible,
the instrument has mesial

Mesial & Distal bevel.

:Hand Instrument Techniques

There are four grasps used

:with the hand instruments
1.Modified pen grasp.
2.Inverted pen grasp.
3.Palm and thumb grasp.
4.Modified palm and thumb
grasp.

Modified Pen Grasp

It is similar to that used in holding a
pen except
that the thumb, index and middle
fingers contact
the instrument while the tips of the
ring and little fingers are placed on
the working tooth as a
The
instrument should not be allowed to rest on the
.rest
first joint of the middle finger as in the conventional
The palm of the hand is facing away
pen grasp. Although this latter position may appear
from
thecomfortable, it limits the application of
to
be more
pressure.
.operator

pen grasp

Modified pen grasp

Inverted Pen Grasp

The hand is rotated so that

the palm faces more toward
the operator.
It is used in the lingual
surfaces of anterior teeth.

Palm-and-Thumb Grasp
The handle of the
instrument is
placed on the
palm of the hand
and grasped by all
the
fingers while the
thumb is free of
the instrument
and rest on the

The palm-and-thumb grasp is similar

to that used for holding a knife while
paring the skin from an apple

Palm-and-thumb grasp. This grasp has limited use,

such as preparing incisal retention in a Class III
preparation on a maxillary incisor. The rest is tip of
thumb on tooth in same arch.

.Modified Palm-and-Thumb Grasp

The same as in palm and

thumb grasp but the thumb
is rested on the tooth being
prepared.
Used in the upper arch.

Modified palm-andthumb grasp allows

greater ease of
instrument movement
and more control
against slippage during
thrust stroke compared
to palm-and-thumb
grasp. The rest is tip of
thumb on tooth being
prepared or adjacent
tooth.

 The modified pen and inverted pen

grasps are used practically universally.
The modified palm-and-thumb grasp
is usually used in the area of the
maxillary arch and is best adopted
when the dentist is operating from a
rear-chair position.

Rests
A proper instrument grasp must include a firm rest to
steady the hand during operating procedures.
When the modified pen and inverted pen grasps are used,
rests are established by placing the ring or ring and little
fingers on a tooth (or teeth) of the same arch and as close
to the operating site as possible.
The closer the rest areas are to the operating area, the more
reliable they are.
When the palm-and-thumb grasps are used, rests are
created by placing the tip of the thumb on the tooth being
operated on, on an adjacent tooth, or on a convenient
area of the same arch.

In some instances, it is impossible to establish a rest on

tooth structure, and soft tissues must be used.

Neither soft tissue rests nor distant hard tissue rests

afford reliable control, and they reduce the force or
power that can be used safely.
Occasionally, it is impossible to establish normal finger rests
with the hand holding the instrument. Under these
circumstances, instrument control may be gained using the
forefinger of the opposite hand on the shank of the instrument
or using an indirect rest, (i.e., the operating hand rests on the
opposite hand, which rests on a stable oral structure).

Instrument Guard
Guards are hand
instruments or other items,
such as inter-proximal
wedges, used to protect
soft tissue from contact
with sharp cutting or
abrasive instruments.

Sharpening Hand Instruments

The cutting edge of the hand
instrument should always be kept
.sharp
:Dull instruments may cause
.Loss of control .1
. More pain .2
Prolonged time for the operative .3
.procedure
Reduce the quality and precision of .4
tooth
.preparation

harpening Equipments
Stationary sharpening stone. 1
e.g. Arkansas stone, silicon
.carbide

Mechanical sharpener; moves. 2

at low
speed while the instrument is
held at the
opposite angle and supported
by a rest
i.e. easier and less time
.consuming